Cardiology Flashcards
(285 cards)
1
Q
At what stage in the cardiac cycle do the coronary arteries fill with blood
A
Diastole
2
Q
What is Sterling’s law of the heart / Frank-starling
A
The greater the stretch of the heart muscles = the greater the force pumped from the heart
3
Q
Where is a collapsing/water hammer pulse heard
A
Aortic regurgitation
4
Q
Define pulses alternans
A
A mix of weak and strong pulses
5
Q
Define Pulsus bigeminus
A
A premature ectopic beat following the normal beat
6
Q
Define Pulsus Bisferiens
A
a Double pulse
7
Q
In what condition is Pulsus bisferiens heard in
A
Hypertrophic cardiomyopathy and mixed aortic valve disease
8
Q
What causes S1 sound
A
Mitral and tricuspid valve closure
9
Q
What causes S2 sound
A
Aortic and pulmonary valve closure
10
Q
What causes an S3 sound
A
HF
11
Q
What causes an S4 soundd
A
Gallop rhythm when the walls harden
12
Q
Carotid sinus syndrome vs Vasovagal syndrome
A
CSS affects elderly vs Young people
13
Q
Define First degree Heart Block
A
PR INterval >0.22 seconds
14
Q
Define Mobitz Type I block
A
Progressive PR interval prolongation til a p wave is skipped
15
Q
Define Mobitz type II Hear block (HB 2)
A
All PR intervals are the same but the p wave skips randomly
16
Q
Define a complete heart block
A
Ventricular rhythm is sustained but electrical impulses fail to reach to the ventricles at all.
So they both beat at different rhythms to each other
17
Q
What artery is most commonly affected in MIs
A
Right coronary artery occlusion
18
Q
What parts of an ECG indicate inferior wall MIs (right coronary artery occlusion)
A
STEMIs in II, III and aVF
19
Q
What condition can cause heart block
A
Lyme Disease
20
Q
What medications can cause heart block
A
beta blockers
CCBs
Adenosine
Amiodarone
Digoxin
21
Q
What heart block is seen in Lyme Disease
A
Third degree AV block
22
Q
Normal QRS complex size
A
3 boxes - 120 ms
23
Q
Affects of bundle branch blocks on QRS complexes
A
Widen them (as delayed time)
24
Q
What does the pneumonic WiLLiaM MaRRoW show us
A
LBBB = W in V1, M in V6
RBBB = M in V1, W in V6
25
Causes of RBBB
Right Ventricular Hypertrophy
RHF
PE
26
What is characteristic of LBBB in V1 leads
Sloping S waves (google)
27
Causes of LBBB
Hypertension
Ischaemia (MIs)
28
What is the most common complication of cardiac surgery
AF (appears 4 days after surgery)
29
HR in AF
300-600 BPM
30
Define Paroxysmal AF
Stops after 7 days
31
Define Persistent AF
>7 Days
32
Define permanent
Continuous with no recovery
33
First Line investigation of AF
ECG
Second Line: 24-hour ECG
34
Purpose of rate control
Bring back rate to 90 BPM
35
First line rate control medication
Atenolol or CCB
Second Line: Digoxin
36
Role of Rhythm control
Brinsg back erratic heart to normal regular rhythm
37
Intervention for rhythm controlling AF
Cardioversion (IV Adenosine)
38
In what people is Cardioversion indicated in
- Recent AF
- <65
- Successful treatment of underlying AF cause
- NO other heart abnormality
- Acute HF made worse by AF
39
Complications of AF
Dilated Cardiomyopathy and strokes
40
What should be done if CHA3Ds@ vast score >2
Offer DOAC
41
If a DOAC is contraindicated for CHA2d2vasc, what should be given
Vit K antagonist
42
When are DOACs often contraindicated for use in AF
<65 with no other risk factors (just sex)
43
What is the ORBIT bleeding risk score
For those on anti-coagulants with AF
44
What needs to be investigated before cardio version
ECHO
45
If cardio version fails, what should be done
Referral to cardiology
46
management of acute AF flare <48 hours
Offer Flecainide or amiodarone to those with no evidence of structural or IHDs
Alternatively offer only Amiodarone if there is evidence
47
Management of acute AF flare >48 hours onset
Delay cardio version + offer beta blockers
48
Flecainide vs Amiodarone
Flecainide = oral
Amiodarone = IV
49
Define Preload
Amount of blood returning to heart
50
Define Afterload
Peripheral resistance to ejected blood
51
Atrial Flutter vs AF
Flutter + regular Heart Rate, just super fast (250-300 BPM)
52
What causes Atrial Flutter
Electrical impulses circle around the Tricuspid valve and move back to the atria instead of all of the impulses going straight to the AV Node -> Ventricles.
53
Management of Atrial FLutter
Anticoagulation 3 weeks before and then cardio version
54
What is Bruggada syndrome
Idiopathic ventricular fibrillation than results in sudden death in South-east asian communities (caused by re-entrant loops)
55
Management of Prolongued QT intervals
Magnseium Sulphate
56
What are Class I drugs
Sodium-channel blockers
57
What are Class II drugs
Prevent the affects of catecholamines on the action potential of the heart
58
What are Class III drugs
Lengthen the action potential running through the heart
59
What are Class IV drugs
Reduce the amplitude of the action potential running through the heart
60
Name a Class I drug
Flecainide and Disopyramide
61
Name a Class II drug
Atenolol
62
Name a Class II drug
Amiodarone
63
IN what condition is catheter ablation first line
WPW syndrome
64
First line investigation of Heart Failure
NT-ProBNP levels
65
What should be done if NT-proBNP level >2,000
Urgent referral and ECHO within 2 weeks
66
Management of those with NT-proBNP levels 400-2,000
Referral to cardiology routinely (within 6 weeks) for ECHO
67
What are normal levels of NT-proBNP levels
<400
68
What else can elevate NT-proBNP levels
Tachycardia
eGFR <60
Age over 70
69
Why is an ECG important in investigating HF
If normal, HF unlikely
70
Staging of HF
NYHA:
1: No symptoms on ordinary physical activity
2: Slight limitation by symptoms
III: Less than ordinary activity leads to symptoms
IV: At rest
71
Medical treatment of Heart Failure
ABAL:
ACEI
Beta blocker
Aldosterone antagonist (spironolactone)
Loop Diuretic
72
Define primary prevention
Patients who have never had a VC disease in the past
73
Define Secondary prevention
Patient that have had angina, an MI, Tia or stroke in the PAST
74
What is used to determine if primary prevention is needed for CVD
QRISK 3
75
What is secondary prevention of CVD
AAAA
Aspirin
Atorvastatin 80mg
Atenolol
AceI
76
Define tertiary prevention
Treatment aimed at reducing the SEVERITY of disease (improve health outcomes)
while secondary is to stop progression of disease to something irreversible
77
What is given if QRISK3 is >10 %
Atorvastatin 20mg
78
Define Prinzmetal's angina
Angina occurring without provocation (not on exertion)
79
Investigations for those with typical angina and disease risk of 10-29%
CT Angiography
80
Investigation of choice for those with angina and disease risk of 30-60%
Stress ECHO and SPECT
81
Investigation of choice for those with angina and disease risk fo 61-90%
Cardiac Catheterisation
82
Management of Stable angina
RAMP:
Refer to cardiology routinely if stable or urgently if unstable
Advise about diagnosis, management and when to call an ambulance
Medical treatment
Proceedural or surgical interventions
83
First line management of angina in patients
NOT surgical, medical first:
GTN - immediate relief
Long term:
Beta blocker or CCB
84
Second line management of stable angina (long term)
Switch to beta blocker and dihydropyridineor Nicorandil
85
When should PCI or CAB be considered for angina
After two lines of medications have failed to control symptoms
86
PCI vs CABG
<65 vs >65 years
Healthy vs Diabetes
87
Which is more effective PCi or CABG
More revascularisation sessions needed with PCI
88
Secondary prevention of angina
AAAA
89
Through which artery is PCI delivered
Femoral Artery
90
Where is the graft vein taken for CABG
Great saphenous vein
91
Where are CABG scars seen
Midline sternotomy
Great Saphenous veins
92
What does the right coronary artery supply
Right atrium
Right ventricle
Inferior left ventricle
93
What does the circumflex artery supply
Left atrium
94
What does the left anterior descending supply
LV and septum
95
What are troponin levels like in unstable angina
Normal
96
How often should troponin levels be repeated
If negative, they need repeating after 4 Horus
97
In which patients are silenT MIs common in
Diabetic patients
98
Signs of NSTEMI on ECG
ST depression
T wave inversion
Q waves
99
What else can cause troponin levels to increase
Sepsis
PE
CKD
100
What serum levels show prognosis of ACS
Troponin levels
101
Management of an acute STEMI
Primary PCI within 2 hours
102
If a primary PCI is contraindicated for STEMI treatment (>12 hours), what can be done
Thrombolysis
103
What thrombolysis is used in STEMI treatment
Streptokinase
104
Management of acute NSTEMI
BATMAN
Betablocker
Aspirin 300mg stat
Ticagrelor
Morphine
Anticoagulant (fondaparinux)
Nitrates
Oxygen only if sats decrease
105
What is a GRACE score
Assess risk of death from MI
106
Complications of MI
DREAD:
Death
Rupture of heart septum
Edema (HF)
Arrythmias
Dressler's syndrome
107
What is Dressler's syndrome
Pericarditis from immune response to MI
108
Signs of Dressler' ssyndrome
Raised CRP and ESR with ST elevation
109
Management of Dressler's syndrome
NSAIDs or steroids
Worst case: Pericardiocentesis as it might come with pericardial effusion
110
Secondary prevention of ACS
AAAAAA (6As)
Aspirin 75mg
Another antiplatelet (clopidogrel or Tica)
Atorvastatin 80mg
ACEI
Atenolol
Aldosterone antagonist
111
How to prevent post operative AF
Give Amiodarone or beta blocker
112
What is always first line for AF
Rate control
113
When is rate control not first line management for AF
When AF is new onset or has other causes
114
When should cardioversion (non pharmaceutical) therapy be offered
When AF has been ongoing for more than 48 hours
115
When is Radiofrequency ablation considered for AF
If drug treatment is unsuccessful
116
What is rheumatic fever
Follows from strrep throat: strep pyogenes has M proteins which molecular mimics the porteins in the myocardium. Causes immune response against myocardium.
Type 2 hypersensitivity reaction
117
What is the Jones' criteria for rheumatic fever diagnosing
1. Migratory polyarthritis
2. Carditis
3. Mitral regurgitation + Stenosis
4. Sydenham's chorea (rapid movement of face and arms)
5. Erythema Marginatum
118
Stenosis vs regurgitation
Stenosis: Prevents adequate outflow of blood
Regurgitation: Leaflets fuse and fail to close = unable to stop back flow of blood
119
Describe the pulse in aortic stenosis
Parvus and Tardus
120
Symptoms of aortic stenosis
Syncope and Angina
121
What is the main cause of mitral regurgitation
Mitral valve prolapse
122
Causes of aortic regurgitation
Infective endocarditis
Biscuspid aortic valve -
123
What manoevure can be done to check for mitral stenosis
Patient lying on left hand side
124
What manoeuvre can be done for aortic regurgitation
Sit up, elad forward and breathe out
125
What valve disease causes hypertrophy of the left atria and ventricle
Mitral and aortic stenosis
126
What valvular disease causes left atrial and ventricular dilatation
Mitral and aortic regurgitation
127
Symptoms of Mitral stenosis
Malar flush and AF
128
Where can aortic stenosis murmurs raidate to
Carotids
129
What is parvus and tardus sound
Slow rising pulse and narrow pulse pressure
130
Where is the austin-flnit murmur typically ehard in aortic regurgitation
Apex (early diastolic rumblinhg murmur)
131
Symptoms of infective endocarditis
Clubbing
Murmurs
Janeway lesions
Osler nodes
Roth Spots in the eyes
SPlinter haemorrhages
132
What are the main types of ASDs seen
Ostium Secondum defects
133
Murmur heard in VSDs
Loud pansystolic murmur in the apex
134
What genetic condition is associated with coarctatin of aorta
Turner Syndrome
135
Symptoms o f coarctation of aorta
COld legs, claudication and headaches
Nose bleeds from hypertension
136
When is balloon dilatation indicated for coarctation of aorta
If peak-peak gradient across coarctation >20 mmHg
137
What is tetralogy of fallot
VSD
Overriding Aorta
RVH
Pulmonary stenosis
138
Most common cause of myocarditis
Coxsackie infection
139
Management of myocarditis
NSAIDs
140
In what conditions is uraemic pericarditis common
CKD patients
141
Most ocmmon cause of viral pericarditis
Coxsackie B
142
Management of recurring pericarditis
Colchicine
143
What is the normal diameter of the aorta
2cm
144
Under what anatomical level do AAAs typically arise from
Below Renal arteries
145
WHat is a pseudoaneurysm
Blood leakage through the qaterial wall but not contained by the adventitia
146
What is an AA
Dilation of all three arterial wall layers as elastic lamellae is degraded
147
Risk Factors for AAA
Male sex
Age
Hyperlipidaemia
148
Symptoms of an unruptured AAA
No symptoms
149
Symptoms of a ruptured AAA
Hypotension and abdominal pain usually
150
What examination can be done to check for an AAA
Supraumbilical palpation
151
GOLD STANDARD investigation for AAA
CT Angiography
152
Three criterions for AAA repairs
Symptomatic
Asymptomatic > 5,5. cm
OR
Asymptomatic, over 4cm and grown by more than 1 cm in a year
153
Management of an AAA between 3 and 4.4cm
Annual USS
154
Management of 4.5-5.5cm AAA
Three monthly USS
155
Define Ejection Fraction
Percentage of the blood in the left ventricle which is pumped out with each heartbeat.
156
How is Ejection Fraction measured
Transthoracic Echocardiography
157
What Ejection Fraction indicates HF
<40%
158
What is a normal ejection fraction
50 or more
159
What drugs can cause HF
Beta blockers, CCBs, Digoxin
160
What is Diastolic HF
Contraction is sufficient but not enough blood is returing to the ventricles
161
What is the Ejection Fraction in Diastolic HF
NORMAL
162
What level is increased in Diastolic HF
Increased End Diastolic Pressure
EDV is normal
163
What causes diastolic HF
Ventricular Hypertrophy
164
What causes Pulmonary Oedema in LHF
Activation of RAAS due to less blood flow to organs = more na+ absorption and oedema
165
Management of Type 1 heart block
Nothing
166
What is the most specific ECG finding in pericarditis
PR Depression and saddle-shaped ST elevation
167
What is Takotsubo cardiomyopathy
Cardiomyopathy induced by stressful triggers
168
At what GRACE score should a CT angiography be sued
>3%
169
What valve is usually affected in infective endocarditis
Tricuspid valve
170
At what Well's score is a D-dimer the investigation of choice for a PE
<4
171
At what Well's score is a CT pulmonarty angiography the invetsigation of choice for a PE
>4
172
Define stage 1 Hypertension
140/90 Clinic or HBPM 135/85
173
Define stage 2 Hypertension
>160/100 at clinic or HBPM/ABPM >150/95
174
Define stage 3 Hypertension
BP > 180 at clinic or diastolic BP >110
175
Management of Bradycardia
Atropine
176
Management of acute heart failure with hypotension
Give inotropes not fluid
177
What factors contribute to dilated cardiomyopathy
Alcoholism
Haemochromatosis
Alcohol
178
Management of acute pericarditis
NSAID + Colchicine
179
Management of pulmonary oedema
IV Fruosemide
180
Signs of Right sided Heart Failure
Raised JVP
Hepatomegaly
Ankle Oedema
181
In what HF is bibasal crackles heard in
Left sided HF
182
In what valve disease is a mid-late diastolic murmur heard?
Mitral stenosis
183
In what valvular disease is an early diastolic murmur heard
Aortic Regurgitation
184
What blood disorder can lead to heart failure
Severe Anaemia
185
Symptoms of Takayasu's arteritis
Weak pulses and claudication in a young woman
186
Management of a Type A Aortic Dissection (ascending aorta)
IV Labetolol + Surgery
187
Management of a Type B (descending) aortic dissection
Iv Labetolol
188
When is prothrombin complex indicated in high INR issues
Only if INR > 8
If 5-8, just stop warfarin and give IV vit K
189
What leads show left anterior descending
V1-V4
190
What ECG leads show activity through the right coronary artery
2,3,aVF
191
What ECG leads show actvity through LAD or left circumflex
V4-6, I, aVL
192
What ECG showed a posterior wall MI
Changes in V1-3
Alongside Q waves
193
What is the management of a tachyarrythmia (e.g., atrial flutter) in the presence of hypotension
DC cardioversion
194
What ECG changes are seen in WPW syndrome
Short PR interval + delta waves
195
What classification can be used to stage limb ischaemia
I - asymptomatic
II - Intermittent Claudication
III - Rest Pain
IV - Necrosis
196
Signs of intermittent claudication
Calf pain on exertion, relieved at rest
197
Investigation for Peripheral vascular disease
ABPI
198
What symptoms does an ABPI of 0.5-0.9 come with
Intermittent claudication
199
WHat ABPI level is indicative of critical limb ischaemia
<0.5
200
Medical management of Peripheral vascular disease
Cilostazol (phosphodiesterase III inhibitor) = vasodilatation
Naftidrofuryl - vasodilator agent
201
Surgical intervention for peripheral vascular disease
Percutaneous transluminal angioplasty
202
What antibiotic can cause long QT syndrome
Erythromycin
203
Management of narrow-complex tachycardia
Vagal manoeuvres
204
Myocarditis vs Pericarditis on an ECG
Myocarditis = ST eleveation
Pericarditis = PR Depression + ST elevation
205
Target INR for PE patients
3-4
206
What is the mechanism of heparin
Activates antithrombin III
207
Management of an INR 5-8
WIthold two doses of warfarin + reduce maintenance dose
208
Management of an INR >8.0
Stop warfarin completely and give vit K
209
What medication should be given for hypertension if ACEi are contraindicated (ie., renal impairment
Amlodipine
210
Examination findings in constrictive pericarditis vs cardiac tamponade
Kussmaul sign is positive in constrictive pericarditis but negative in cardiac tamponade (a raised JVP that DOESN'T FALL on inspiration)
211
Common cause of cardiac tamponade
Recent cardiac surgery
212
What ECG leads are anteroseptal MIs seen in
V1-4
213
Wga t ECG changes show an MI in the anterolateral leads
V4-6, I, aVL
214
What are adverse signs in a patient that means someone with AF must be given DC cardioversion as first line
Systolic pressure < 90mmHg
Signs of shock
Syncope
Ongoing MI
HF
215
How many times can cardioversion be given
Up to three shocks -> then ask consultant
216
First line management of narrow-complex tachycardia
Vagal maneuvres followed by IV adenosine
217
What is a common cause of pulseless electrical activity
Tension pneumothorax
218
What ECG change is seen in a PE
Sinus Tachycardia
219
What does torsades de pointes look like on an ECG
Polymorphic ventricular tachycardia
220
What neurological condition can cause torsades de pointes
SAH
221
Treatment of HF refractory to ABAL
CPAP
222
Prophylactic management of Hypertrophic Cardiomyopathy
Amiodarone
223
Admitting a patient for PCI vs coronary angiogram for Mis
PCI = unstable patient
Angiogra, = stable + Grace score >3%
224
What drugs specifically are used in PCI and thrombolysis
Prasugrel + Unfractionated heparin + glycopreotein IIb/IIIa inhibitor
225
What is seen in leads V1-3 for arrythmogenic right ventricular cardiomyopathy
T wave inversion s
226
What ventricle hyperthrophs in hypertrophic obstructive cardiomyopathy
Left
227
What murmur is associated with marfan's syndrome
Mitral regurgitation
228
What dose of adrenaline is given for anaphylaxis
500mcg
229
Features of heart failure on an X-Ray
Alveolar oedema (bat's wings)
Kerly B lines (interstitial Oedema)
Cardiomegaly
Dilaeted prominant upper lobe vessels
Pleural Effusions
ABCDE
230
How long does it take for a cough to resolve in pneumonia
3-6 months
231
Management of all cases of pneumonia at 6 weeks of clinical resolution
Repeat Chest-X ray to look for emphysema
232
Managemnt of patients with COPD and pneumonia but no exacerbation
Give prednsiolone anyways
233
Prevention of Peripheral Arterial Disease
Atorvastatin 80mg + Clopidogrel
234
Surgical management of PAD
Endovasuclar revascularisation (trnsluminal angiplasty + stent) - if <10cm stenosis
Surgical revascularisation (surgical bypass with autologous vein) - if >10 cm stenosis
235
Initial management of acute limb ischaemia
Paracetamol
Codeine
Iv Heparin
Vascular review
236
Initial investigation of acute limb-theratening ischaemia
hand held arterial doppler THEN an ABI
237
What is a normal ABPI
1-1.2
238
Management of an ABPI <0.5
Urgent referral
239
What indicates PAD on an ABPI
<0.9
240
Features of acute limb ischaemia
Pain
Pulseless
Pallor
Power loss
Paraesthesia
Perishing with cold
241
Management of intermittent claudication
First LIne: Supervised excercise
Second Line: Unsupervised excercise
third Line: Referral for angioplasty
242
Management of critical limb ischaemia
Urgent referal + paracetamol (pain ladder)
243
Is there pain in a neuroptahic ulcer
No
244
Acute vs critical limb isdhaemia
Critical: caused gradually
Acute: Acute
245
In what patients is adenosine contraindicated in
Asthmatics (causes bronchspasm)
246
What antiplatlet therapy sould be given in ACS
Aspirin (lifelong) + Ticagrelor (12 months)
247
Second line management of ACS (antiplatelet therapy)
Clopidogrel
248
First line prevention of AF post-stroke
Warfarin or DOAC/NOAC
should be commenced 2 weeks after a stroke
249
Three ECG signs that may indicate ischaemia or previous MI
Pathological Q waves (mainly)
LBBB
T wave abnormalities
250
How long after should response to treatment in angina be followed up
4 weeks
251
What antiplatelet should be given for people with stable angina
75mg Aspirin daily
If someone's had a storke: clopidogrel instead
252
Can GTN sprays be taken alongside phosphodiesterase inhibitors
No - there should be at least 12 hours interval between taking the two medications
253
If angina is present at rest, should someone be allowed to travel
No - unlrss inflight oxygen is available
254
How often should someone with angina be reviewed
6 months to a year
255
What is a Holter monitor
7 day ECG monitor if a 24 hour is not avilable
256
Under what Oxygen sats should oxygen therapy be given
94% or less
257
How do we manage oxygen therapy in acutely ill patients (non COPD)
Start at 15 L/min and then reduce
Unless hypercapnia is present
258
Under what ALS situation is defibrillation contraindicated
Asystole or pulseless electrical actviity
259
Management of Ventiruclar fibrillation or ventricular tachycardia
CPR with a 30:2 ratio
Give three shocks:
Then adrenaline 1 mg IV and Amiodarone 300mg IV
260
Management of asystole
CPR
Then give 1mg Adrenaline IV
Then adrenaline every 3-5 minutes
261
At what ABPI are compression stockings indicated
0.8-1.3
262
What is the first line management of erectile dysfunction for non-invasive drug free managemen
Vaccuum eerectiond evices
263
What is a pathological Q wave
>1 square wide
264
Where are pathological q waves seen
V1-3
265
What does a pathological q wave indicate
Previous MIs
266
In what conditions are inverted t waves seen in
Ventricular hypertrophy
PEs
Hypertrophic cardiomyopathy
267
Name three metabolic disturbances that can cause prolongued QT
Hypokalaemia
Hypomagnesaemia
Hypocalcaemia
268
What leads show issues with the LAD
V1-V4 (inferior leads)
269
What is diagnostic for dextrocardia in an ECG
Inverted p wave in lead I
270
IN what CVcondition is raynauds commonly seen in
Buerger's disease
271
What investigation must be done before discharging a patient on AF
Arrange an ECHO cardiogram
272
Investigation of choice in an aortic dissection
CT Angiography - shows a false lumen
Second line: Transoesophageal echocardiography
273
Should statins be given during pregnancy
No
274
What is the first line investigation for angina
CT angiogrpahy
275
At what K+ level should ACE-inhibitors be stopped
>6 mmol/L
276
What part of the heart hypertrophs in Obstructive Cardiomyopathy
Septum of the LV
277
What is seen on a Chest X-Ray for people with aortic dissections
Widened Mediastinum
False lumen typically only in CTs
278
In what condition are kerley b lines found
Congestive cardiac failure
279
What serum level is checked for re-infarctions in MIs
CK-MB
Troponin remains elevated for 10 days vs CK-MB which is 3 days. So more accurate in acute settings
280
Management of AF if the episode has been ongoing for 48 hours
Anticoagulate for 3 weeks and DELAY cardioversion.
Check ECHO and the cardiovert
281
After fibrinolysis is done for a STEMI, when should an ECG be repeated
Within 60-90 minutes, and then send for urgent PCI if this has not resolved.
282
What is diagnostic for an aortic dissection
CT tomography angiography of the chest, abdomen and pelvis
NOT CT coronary angiography
283
When should someone with high BP be referred to hospital
>1280/120 or if phaeochromocytoma is suspected
284
First line investigation of high blood pressure
Ambulatory Blood Pressure Monitoring
Second Line: HBPM
285
Sounds heard in an atrial septal defect
Ejection-Systolic Murmur louder on inspiration + Fixed S2 split
